Media reporting on alcohol and other drugs in Australia and the Mindframe guidelines: Baseline data

INTRODUCTION

The aim of this study was to generate a baseline database of print media reporting on alcohol and other drug (AOD) issues prior to the release of the Mindframe guidelines in March 2019. Specifically, to: (i) describe the content associated with media entries that focus on AOD use in Australian news media; (ii) determine how the media entries compare to several domains associated with recently developed Mindframe guidelines for publicly reporting on AOD; and (iii) identify content factors associated with different scores.

METHODS

Media entries between July 2016 and June 2017 were searched for key AOD-related terms using the Australian and New Zealand Newsstream database. Two coding schemes were developed to rate a stratified sample of 50% of the media entries against the Mindframe guidelines. Associations between content and total comparison scores were determined using linear regression models.

RESULTS

Detailed coding of the 2007 articles identified as relevant for the current study indicated that a majority (67%) were focused on one of three substances: alcohol, cannabis or methamphetamine. Most of the entries were either law enforcement (22%) or criminal justice related (19%). Entries that focused on methamphetamine scored significantly lower than entries on alcohol when compared to the Mindframe guidelines, similarly entries focused on crime/justice-related topics scored significantly lower than entries focused on positive outcomes.

DISCUSSION AND CONCLUSIONS

A disproportionate number of print media entries, particularly those related methamphetamine use, focused on crime or justice-related topics, potentially further contributing to stigma, and emphasising the legal consequences of AOD use.

Mass media to communicate public health messages in six health topic areas: a systematic review and other reviews of the evidence

Background

Mass media campaigns can be used to communicate public health messages at the population level. Although previous research has shown that they can influence health behaviours in some contexts, there have been few attempts to synthesise evidence across multiple health behaviours.

Objectives

To (1) review evidence on the effective use of mass media in six health topic areas (alcohol, diet, illicit drugs, physical activity, sexual and reproductive health and tobacco), (2) examine whether or not effectiveness varies with different target populations, (3) identify characteristics of mass media campaigns associated with effectiveness and (4) identify key research gaps.

Design

The study comprised (1) a systematic review of reviews, (2) a review of primary studies examining alcohol mass media campaigns, (3) a review of cost-effectiveness evidence and (4) a review of recent primary studies of mass media campaigns conducted in the UK. A logic model was developed to inform the reviews. Public engagement activities were conducted with policy, practitioner and academic stakeholders and with young people.

Results

The amount and strength of evidence varies across the six topics, and there was little evidence regarding diet campaigns. There was moderate evidence that mass media campaigns can reduce sedentary behaviour and influence sexual health-related behaviours and treatment-seeking behaviours (e.g. use of smoking quitlines and sexual health services). The impact on tobacco use and physical activity was mixed, there was limited evidence of impact on alcohol use and there was no impact on illicit drug behaviours. Mass media campaigns were found to increase knowledge and awareness across several topics, and to influence intentions regarding physical activity and smoking. Tobacco and illicit drug campaigns appeared to be more effective for young people and children but there was no or inconsistent evidence regarding effectiveness by sex, ethnicity or socioeconomic status. There was moderate evidence that tobacco mass media campaigns are cost-effective, but there was weak or limited evidence in other topic areas. Although there was limited evidence on characteristics associated with effectiveness, longer or greater intensity campaigns were found to be more effective, and messages were important, with positive and negative messages and social norms messages affecting smoking behaviour. The evidence suggested that targeting messages to target audiences can be effective. There was little evidence regarding the role that theory or media channels may play in campaign effectiveness, and also limited evidence on new media.

Limitations

Statistical synthesis was not possible owing to considerable heterogeneity across reviews and studies. The focus on review-level evidence limited our ability to examine intervention characteristics in detail.

Conclusions

Overall, the evidence is mixed but suggests that (1) campaigns can reduce sedentary behaviour, improve sexual health and contribute to smoking cessation, (2) tobacco control campaigns can be cost-effective, (3) longer and more intensive campaigns are likely to be more effective and (4) message design and targeting campaigns to particular population groups can be effective.

Future work

Future work could fill evidence gaps regarding diet mass media campaigns and new-media campaigns, examine cost-effectiveness in areas other than tobacco and explore the specific contribution of mass media campaigns to multicomponent interventions and how local, regional and national campaigns can work together.

Study registration

This study is registered as PROSPERO CRD42015029205 and PROSPERO CRD42017054999.

Funding

The National Institute for Health Research Public Health Research programme.

The Roles of Prevention Messages, Risk Perception, and Benefit Perception in Predicting Binge Drinking among College Students

To account for the effect of prevention-message exposure on binge drinking among college students, I hypothesized a conceptual model outlining potential mechanisms including perceived probability of negative consequences (PPNC), perceived severity of negative consequences (PSNC), perceived probability of positive consequences (PPPC), and perceived beneficiality of positive consequences (PBPC) from binge drinking, based on the two-step process model. I conducted an online survey at a public university in the US (N = 278). Findings suggested only PBPC was significantly related to binge drinking and the relationship was positive; prevention-message exposure was not directly associated with binge drinking, but was positively associated with PPNC, PSNC, PPPC, and PBPC; none of the mediational paths was significant; higher risk perception (interaction between PPNC and PSNC) was significantly related to less binge drinking, while benefit perception (interaction between PPPC and PBPC) was not predictive of binge drinking. Implications of findings were discussed.

Is popular radio a source of exposure to alcohol references in mid to later life? A content analysis

Background

There is concern around alcohol consumption in mid to later life yet little understanding about what influences this behaviour. No previous research has explored the extent to which adults in mid to later life may be exposed to alcohol references in the media. This project aimed to determine the frequency of alcohol references on radio stations with a high proportion of listeners in mid to later life.

Methods

Content analysis of alcohol references on four popular UK music-based radio stations with a high proportion of listeners aged 55-64 years over three time points.

Results

Alcohol references occur frequently, but vary by time of year and type of radio station. When alcohol is mentioned its consumption is portrayed as the norm, without negative consequences. On three commercial stations, the majority of mentions came from advertising, whereas on BBC Radio 2 nearly all references were talk-based. All adverts for direct promotion of alcohol were by supermarkets. Alcohol was frequently associated with celebrations, socializing or something to consume for its own sake.

Conclusions

Adults in the age group 55-64 may be exposed to references to alcohol that could serve to reinforce norms of consumption of alcohol and promote purchases of cheap alcohol.

Unrealistic optimism with regard to drinking during pregnancy among women of childbearing age in a South African community

Drinking alcohol during pregnancy is a risk factor in a range of adverse birth outcomes, including fetal alcohol spectrum disorders, and is a major health concern. For this behaviour to change one of the necessary conditions is for women to have an accurate perception of the risks drinking during pregnancy poses. A major obstacle to this is the presence of unrealistic optimism which leads to women believing they are less at risk than others. This study examined a sample of women ( N = 129) from a community in the Northern Cape Province in South Africa with a high prevalence of fetal alcohol spectrum disorder for signs of unrealistic optimism. A questionnaire about the perception of personal and general risk was administered during a one-on-one interview and responses compared. Neither a Student’s t-test ( t(115) = −1.720, p = .088, 95% confidence interval [−0.180, 0.013]) nor a Wilcoxon matched-pairs signed-rank test ( z = −1.72, p = .285) showed a significant difference. The perception of risk posed by drinking during pregnancy to others, knowledge of fetal alcohol spectrum disorder, and the perception of how easy it would be for the participant to quit drinking were significant predictors of the perception of personal risk. Only the perception of personal risk predicted the perception of general risk. There was no evidence that participants believed themselves to be less at risk than their peers when it came to the risks of drinking during pregnancy. Future directions for research into unrealistic optimism and drinking during pregnancy are discussed.

Debiasing Health-Related Judgments and Decision Making: A Systematic Review

BACKGROUND

Being confronted with uncertainty in the context of health-related judgments and decision making can give rise to the occurrence of systematic biases. These biases may detrimentally affect lay persons and health experts alike. Debiasing aims at mitigating these negative effects by eliminating or reducing the biases. However, little is known about its effectiveness. This study seeks to systematically review the research on health-related debiasing to identify new opportunities and challenges for successful debiasing strategies.

METHODS

A systematic search resulted in 2748 abstracts eligible for screening. Sixty-eight articles reporting 87 relevant studies met the predefined inclusion criteria and were categorized and analyzed with regard to content and quality. All steps were undertaken independently by 2 reviewers, and inconsistencies were resolved through discussion.

RESULTS

The majority of debiasing interventions ( n = 60) was at least partially successful. Optimistic biases ( n = 25), framing effects ( n = 14), and base rate neglects ( n = 10) were the main targets of debiasing efforts. Cognitive strategies ( n = 36) such as "consider-the-opposite" and technological interventions ( n = 33) such as visual aids were mainly tested. Thirteen studies aimed at debiasing health care professionals' judgments, while 74 interventions addressed the general population. Studies' methodological quality ranged from 26.2% to 92.9%, with an average rating of 68.7%.

DISCUSSION

In the past, the usefulness of debiasing was often debated. Yet most of the interventions reviewed here are found to be effective, pointing to the utility of debiasing in the health context. In particular, technological strategies offer a novel opportunity to pursue large-scale debiasing outside the laboratory. The need to strengthen the transfer of debiasing interventions to real-life settings and a lack of conceptual rigor are identified as the main challenges requiring further research.

A Longitudinal Study of Adolescents' Optimistic Bias about Risks and Benefits of Cigarette Smoking

OBJECTIVES

Optimistic bias, a perception that one's own risks are lower than others', can help explain why adolescents smoke cigarettes despite knowing their risks. We examined the extent and changes over time of adolescents' optimistic bias for various smoking-related perceptions of risks and benefits on the aggregate and individual level.

METHODS

Longitudinal study (6 measurements over 3 years) of 395 adolescents (mean age 14 years, SD=0.4, at baseline) who rated the chance of occurrence of 19 short- and long-term heath risks, social risks, addiction, and benefits related to cigarette smoking for self and comparable others.

RESULTS

Optimistic bias was consistently found only for addiction (83% of comparisons; 37%- 60% of adolescents). Addiction-related optimistic bias decreased significantly with time for "still be smoking in 5 years" (β = -2.44, p < .001) and for "become addicted" (β = -1.71, p < .001). This reduction resulted from a greater decrease in perceived risks for others rather than an increase in the adolescent's own perceived risk. For other risks and benefits, adolescents were either realistic or pessimistically biased.

CONCLUSIONS

Smoking-related optimistic bias in adolescents was not as prevalent as past studies showed. Anti-smoking interventions targeting adolescents should emphasize the risk of addiction and personal relevance of addiction.

Intensive alcohol consumption by adolescents in Southern Spain: The importance of friendship

BACKGROUND

There has been an increase in intensive alcohol drinking by Spanish adolescents since the 1990s, especially among the females, but there has been limited exploration of this phenomenon. The objective of this study was to analyse the discourses of Spanish adolescents on their drinking behaviour at contextual, relational, and personal levels.

METHODS

A qualitative study was undertaken in 96 adolescents aged between 14 and 17 years who had experienced at least one intensive drinking episode during the previous year. They lived with family members and were not offenders or at risk of social exclusion. Participants were recruited at educational centres and youth centres in two provinces in southern Spain. Ten focus groups and 30 in-depth individual interviews were conducted. A summative content analysis was performed.

RESULTS

Intensive alcohol drinking was widely practiced in this study population. Consolidation of this practice was influenced by cultural, interpersonal and personal dimensions. Consumption in public spaces emerged as a key influential factor, especially the botellón, a collective space-time in which Spanish adolescents socialize and become initiated into intensive alcohol consumption. Besides the facilitating elements of the social and cultural setting, the results also evidence the effects of interpersonal relationships within the peer group, which offer a series of approaches to risk and protective practices. In these adolescents, the main reason for engaging in alcohol drinking was to enhance their social relationships, which acted as a mechanism to normalize intensive alcohol consumption.

CONCLUSIONS

Policies to reduce the harm caused to adolescents by intensive alcohol drinking need to take account of the contextual, relational and personal dimensions of this practice. The discourses of these adolescents from Southern Spain point to a potential role for the peer group in harm reduction strategies.

'A Drink That Makes You Feel Happier, Relaxed and Loving': Young People's Perceptions of Alcohol Advertising on Facebook

AIMS

To explore young people's perceptions of alcohol advertising on Facebook and investigate perceived compliance with the Alcohol Beverages Advertising Code (ABAC).

METHODS

An online cross-sectional survey with 172 Australians aged 16-29 years recruited from a market research website and via Facebook. We compiled advertisements from six popular alcohol brands' Australian Facebook pages and asked respondents for their perceptions and interpretations in open and closed-ended questions.

RESULTS

Open-ended responses most commonly indicated that the main messages of the advertisements related to social success. In closed-ended questions, respondents perceived advertisements implied that alcohol facilitated relaxation (67%), improved mood (65%), social success (57%) and confidence (49%).

CONCLUSION

Young people identified the main themes of alcohol advertising on Facebook as related to social success and significant improvement in mood. Young people's interpretations of Facebook alcohol advertising suggest breaches of ABAC guidelines. Strengthening the enforcement and application of the ABAC and social media alcohol advertising policies is justified.

Message Formats, Numeracy, Risk Perceptions of Alcohol-Attributable Cancer, and Intentions for Binge Drinking Among College Students

We conducted an experiment to examine whether risk perceptions of alcohol-attributable cancer influence college students' binge-drinking intention and to explore how message formats (text, table, and graph) and numeracy influence risk perceptions of alcohol-attributable cancer. We found that a majority of participants (87%) perceive some risks of alcohol-attributable cancer. Risk messages in tabular and graphic formats are more effective in elevating risk perceptions, but there is no significant difference between these two formats. Numeracy and its interaction with message formats, however, do not predict risk perceptions. We recommend risk messages should be delivered using tabular or graphic formats to enhance risk perceptions. We also advocate the less-is-more principle in presenting risk information.

Adolescent perceptions of alcohol risk: variation by sex, race, student activity levels and parental communication

Drawing on data gathered from adolescents (N = 18,991) in the 2011 National Survey on Drug Use and Health (NSDUH), this study examined the effects of sex and race, as well as measures of student activity levels and frequency of recognition from parents, on perceptions of the risks associated with binge drinking. Overall, female, Black, Asian, and Hispanic adolescents, as well as individuals who indicated belonging to more than one race, perceived higher levels of risk. Male, White, and Native American/Alaskan/Pacific Islander respondents perceived lower risk levels. In addition, those who participated the most in school and community activities, as well as those who received more frequent recognition from parents, estimated higher levels of risk associated with binge drinking.

'Drinking is our modern way of bonding': young people's beliefs about interventions to encourage moderate drinking

Efforts to discourage excessive alcohol use among young people can only be effective if the target audience is exposed to, attends to, and comprehends key messages. The aim of this study was to examine age and sex differences in drinking motives to better inform development of targeted interventions to reduce alcohol-related harm. Thirty individual interviews and 12 group interviews were conducted with English 13-25 year olds. Interviewees gave multiple motivations for drinking - especially those related to image and reputation, and played down the health implications of heavy drinking. Negative aspects of drinking - caring for drunk friends, being cared for when drunk and suffering through hangovers with friends - were considered to offer opportunities for closer interpersonal bonding than other social activities. Respondents distanced themselves from 'problem' drinkers, but disapproved of others' problematic drinking or antisocial behaviour. Narrative messages demonstrating the social consequences of excessive consumption were preferred to single, static messages emphasising risk or harm. Interviewees noted that interventions must use an engaging tone or pitch: they considered many campaigns to be patronising or preaching. A lack of consensus between age and sex groups highlighted a need for multifaceted, multi-modal approaches that utilise mobile technologies and new media.

"Let's get Wasted!" and Other Apps: Characteristics, Acceptability, and Use of Alcohol-Related Smartphone Applications

Background

Smartphone applications (“apps”) offer a number of possibilities for health promotion activities. However, young people may also be exposed to apps with incorrect or poor quality information, since, like the Internet, apps are mostly unregulated. Little is known about the quality of alcohol-related apps or what influence they may have on young people’s behavior.

Objective

To critically review popular alcohol-related smartphone apps and to explore young people’s opinions of these apps, their acceptability, and use for alcohol-related health promotion.

Methods

First, a content analysis of 500 smartphone apps available via Apple iTunes and Android Google Play stores was conducted. Second, all available blood alcohol concentration (BAC) apps were tested against four individual case profiles of known BAC from a previous study. Third, two focus group discussions explored how young people use alcohol-related apps, particularly BAC apps.

Results

384 apps were included; 50% (192) were entertainment apps, 39% (148) were BAC apps, and 11% (44) were health promotion and/or stop drinking–related apps. When testing the BAC apps, there was wide variation in results, with apps tending to overestimate BAC scores compared with recorded scores. Participants were skeptical of the accuracy of BAC apps, and there was an overall concern that these apps would be used as a form of entertainment, further encouraging young people to drink, rather than reduce their drinking and risk taking.

Conclusions

The majority of popular alcohol-related apps encouraged alcohol consumption. Apps estimating blood alcohol concentration were widely available but were highly unreliable. Health departments and prominent health organizations need to endorse alcohol smartphone apps that are accurate and evidence-based to give specific apps credibility in the ever-expanding market of unregulated apps.

Changing smokers’ risk perceptions – for better or worse?

This study investigated the effect of a smoking health message on smokers’ comparative optimism. Two groups watched an anti-smoking scenario, with one group imagining being part of the scenario. Participants, including controls, completed comparative optimism ratings for four smoking-related illnesses. The intervention had negative consequences with both intervention groups reporting significantly higher comparative optimism versus the control group for all four smoking-related illnesses. It is concluded that media health messages can be powerful tools in changing comparative optimism but are influenced by peoples’ prior perceptions. Health messages need to be systematically assessed to understand prior beliefs of the target audience.